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Kaiser Permanente Medicare Advantage Key Snohomish (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Kaiser Permanente Medicare Advantage Key Snohomish (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Kaiser Permanente Medicare Advantage Key Snohomish (HMO) in 2026, please refer to our full plan details page.
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) is a HMO plan offered by Kaiser Foundation Health Plan, Inc. available for enrollment in 2026 to people living in Snohomish. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Kaiser Permanente Medicare Advantage Key Snohomish (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Kaiser Permanente Medicare Advantage Key Snohomish (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Kaiser Permanente Medicare Advantage Key Snohomish (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6750.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Kaiser Permanente Medicare Advantage Key Snohomish (HMO) plan features no drug deductible, meaning your prescription coverage begins immediately. For Tier 1 preferred generics, you will pay no copay for standard mail orders, while preferred pharmacy copays start at just $3 for a one-month supply. Tier 2 generic drugs also offer budget-friendly options, including no copay for two- and three-month standard mail orders and a $10 copay at preferred pharmacies. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs carry a $47 and $99 one-month copay respectively, with savings available on three-month standard mail orders. Specialty medications in Tier 5 require a 31% coinsurance across all pharmacy options, whereas Tier 6 vaccines are highly accessible with no copay for a one-month supply at both preferred and standard pharmacies.
Additional Benefits
The Kaiser Permanente Medicare Advantage Key Snohomish (HMO) plan features comprehensive healthcare coverage with no copay for primary care visits, annual physicals, and preventive screenings. Specialist visits require a copay of up to $50, while emergency room visits carry a $130 copay that is waived if you are admitted. For inpatient hospital stays, members pay a $435 daily copay for days one through five, followed by no copay for days six through 90. This plan also offers no copay for home health services and routine vision exams, plus a $150 annual eyewear allowance. While diagnostic lab work and diabetic supplies have no copay, durable medical equipment and dialysis services require a 20% coinsurance. It is important to note that routine dental care, hearing aids, and routine transportation are not covered under this plan.
Inpatient Hospital See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $435 daily copay for days 1 through 5 and no copay for days 6 through 90. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) covers outpatient services with no coinsurance, featuring copays of $0 to $400 for outpatient hospital services and $400 for ambulatory surgical center visits. Outpatient substance abuse sessions require a $35 to $45 copay with no coinsurance, while outpatient blood services are covered with no copay, coinsurance, or deductible.
Partial Hospitalization See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) covers partial hospitalization with a $140.00 copay and no coinsurance. Prior authorization and a referral are required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Kaiser Permanente Medicare Advantage Key Snohomish (HMO), offering ground and air ambulance services with a $300 copay and no coinsurance, subject to prior authorization. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $50 to $300.
Primary Care See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) covers primary care and telehealth services with no copay and no coinsurance, whereas specialist visits, therapy, and mental health services require copays up to $50 with no coinsurance. Chiropractic care is partially covered, offering routine services for a $15 copay and no coinsurance (other chiropractic services are not covered), while podiatry services are not covered.
Preventive Services See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and screenings. Additional preventive benefits are partially covered with no copay and no coinsurance for fitness, smoking cessation, and remote access; however, health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, safety devices, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by Kaiser Permanente Medicare Advantage Key Snohomish (HMO), which offers hearing exams with no deductible and no coinsurance, but does not cover prescription or over-the-counter hearing aids. Covered exams include one routine exam per year with a $0 to $50 copay and one fitting evaluation with no copay.
Vision Services See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) covers vision services with no coinsurance, featuring a $0 to $50 copay for one routine eye exam per year and a $150 annual allowance for eyewear with no copay. Other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) partially covers dental services, providing coverage only for Medicare-covered dental benefits with a $50 copay and no coinsurance. Non-Medicare dental services, including routine cleanings, oral exams, x-rays, preventive care, restorative services, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the Kaiser Permanente Medicare Advantage Key Snohomish (HMO) with no copay, though prior authorization is required. Under this benefit, Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the Kaiser Permanente Medicare Advantage Key Snohomish (HMO) plan with no copay and a 20% coinsurance. Prior authorization and a referral are required to receive this covered benefit.
Medical Equipment See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance, subject to prior authorization. Diabetic equipment, supplies, and therapeutic shoes or inserts are also covered under prior authorization with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) covers diagnostic services with no coinsurance, offering no copay for lab work and a $20 copay for diagnostic procedures. Covered radiological services require a $15 copay plus coinsurance for X-rays, a $375 copay for diagnostic radiology, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under the Kaiser Permanente Medicare Advantage Key Snohomish (HMO) plan with no copay and no coinsurance. Members will need to obtain a referral and prior authorization before receiving these services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under the Kaiser Permanente Medicare Advantage Key Snohomish (HMO) with no coinsurance, though prior authorization and referrals are required. While some services are covered, specific sub-services such as cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for peripheral artery disease are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Kaiser Permanente Medicare Advantage Key Snohomish (HMO) with no coinsurance and do not require a prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though prior authorization and referrals are required, and additional days beyond day 100 are not covered.
Other Services See details
Kaiser Permanente Medicare Advantage Key Snohomish (HMO) does not cover other supplemental services, meaning there is no coverage for acupuncture, over-the-counter (OTC) items, or meal benefits under this plan.
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